CMS Price Transparency Data

Total hip replacement

Facility: Crystal Clinic Orthopaedic Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $1,813
Cash Discount Price: $5,425
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Crystal Clinic Orthopaedic Center is $1,813. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,425. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.14x the Medicare baseline. Located in 444 North Main Street, Akron, OH.

Cash / Self-Pay

$5,425

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,813

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$13,116.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13,116.76 (100%)

Cash / Self-Pay: $5,425 (41%)

Insurance Median: $1,813 (14%)

Cash: $5,425 (41% of Medicare)

Ins. Median: $1,813 (14% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13,116.76 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Bc Mcr Adv	$1,129	9%
Summacare Mcr Adv	$1,129	9%
UnitedHealthcare	$1,219 - $1,874	9%
Summacare Comm - All Other Plans	$1,231	9%
Aultcare - All Plans	$1,242	9%
Aetna	$1,246	9%
The Health Plan - All Plans	$1,468	11%
Cigna	$1,607	12%
Med Mutual Nas	$1,782	14%
Bc Blue Access	$1,813	14%
Bc Ohi/Ohii	$1,813	14%
Bc Pathway	$1,813	14%
Bc Preferred	$1,813	14%
Bc Trad - All Other Plans	$1,813	14%
Health Oh Network - All Plans	$4,340	33%
Ohio Health Choice - All Plans	$4,340	33%
Multiplan - All Plans	$4,774	36%
Healthsmart - All Plans	$6,148	47%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $5,425.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 27130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Crystal Clinic Orthopaedic Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 27130.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.